AccountId: 011433970860
ContactId: aebd8321-febd-4538-aef0-1526929e05be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 156119 ms
Total Talk Time (AGENT): 36739 ms
Total Talk Time (CUSTOMER): 62829 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/aebd8321-febd-4538-aef0-1526929e05be_20250415T16:12_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] with Southeast Dermatology. I have a question regarding an outstanding claim, please.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] I do. It's 02107804. The patient is [PII].
[CUSTOMER][NEUTRAL] And the last name is [PII]
[AGENT][NEUTRAL] And what was that date of service?
[CUSTOMER][NEUTRAL] Date of service is [PII] for $499.
[CUSTOMER][NEUTRAL] Did I say [PII]?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Got to think about, got to think about that. I mean, wait a minute. I think I sent you the wrong date.
[AGENT][NEUTRAL] Let's see what we've got here. OK, um let's.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, looks like we denied the claim. Outpatient benefit for the calendar year has been met.
[CUSTOMER][NEUTRAL] So patient is responsible for anything about anything uh remaining, right?
[AGENT][NEUTRAL] Uh, we don't determine patient responsibility as a secondary policy. We just process according to the plan.
[CUSTOMER][NEUTRAL] OK, so tell me again, they have that you denied based on what?
[AGENT][NEUTRAL] Your outpatient maximum was meant dollar amount.
[CUSTOMER][NEUTRAL] OK. Outpatient Max. OK.
[CUSTOMER][POSITIVE] OK. Alrighty, it's what I needed to know. Thank you so much.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.